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In most countries preventive health care has always been an important element of health service provision, with prevention a stated aim of most health services. Yet in most of the developed nations, the resources allocated to prevention are greatly outweighed by the resources consumed by the acute – mainly hospital – sector. Paradoxically, this is the same sector which is experiencing increasing demands to treat preventable disease and injury. In England, we have recently witnessed the first NHS hospital Trust being placed into administration, a euphemism in this case for having failed to be able to remain financially viable. Despite improving objective, externally determined quality ratings and patient satisfaction, and strong clinical leadership, the NHS Trust found that the demands …